An Unusual Proximal Tibia Physis Injury in an Adolescent

Tibial tuberosity fractures are uncommon but are usually seen in adolescents approaching skeletal maturity. Typically this fracture results from an avulsion of the tibial tuberosity as the powerful quadriceps overcome skeletal strength in passive flexion. We present the case of a 17-year-old female who presented with severe pain in her left knee sustained after stepping off a curb. She had no significant past medical history apart from a raised body mass index (BMI) of 46. Radiographs demonstrated that she had sustained a rare type of physeal injury not previously reported in the literature. This unique fracture developed along the physeal scar but interestingly the anterior cortex remained intact. Closed reduction of this fracture was attempted and the fracture healed uneventfully leaving a slight asymptomatic positive slope on the tibia.